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Öğe Assessment of Comorbid Psychopathologies, Psychosocial Factors and Psychiatric Treatment Approach in Children and Adolescents with Sleep Bruxism(2024) Abanoz, Elif; Şireli, Özlem; Ucuz, İlknur; Cicek, Ayla UzunBackground: Previous studies have revealed a close relationship between a variety of psychopathologies and psychosocial factors, and bruxism. However, psychosocial factors and psychiatric difficulties in children and adolescents with bruxism have not been extensively studied. In the current study, we sought to examine the sociodemographic characteristics, psychosocial factors, and comorbid psychopathologies of children and adolescents with sleep bruxism. Materials and Methods: The study included 67 children and adolescents between the ages of 4-17 who were diagnosed with sleep bruxism and followed up at two different Child and Adolescent Psychiatry outpatient clinics between 2018 and 2024. Data on behavioral and emotional characteristics and comorbid psychiatric disorders of these patients, clinical features of bruxism, and treatment approaches to bruxism were retrospectively investigated. Results: Our results indicated that 41.8 of the sample had at least one comorbid psychiatric disorder, and 10.4% had subthreshold psychiatric symptoms. The most common comorbid psychiatric disorders were anxiety disorders, attention deficit hyperactivity disorder, nocturnal enuresis, and conduct disorders. In 41.8% of cases, bruxism was linked to psychosocial factors. Comorbid psychiatric disorders were significantly more prevalent in the school and adolescent age groups than in preschoolers. Similarly, the connection between bruxism and psychosocial factors became more evident with age. The frequency of a positive family history of bruxism was 44.8%. As treatment options for bruxism, the behavioral approach and pharmacotherapy were preferred in 88.1% of cases, and only the behavioral approach was applied to 11.9%. The most common drugs used in pharmacotherapy were hydroxyzine, tricyclic antidepressants, antipsychotics, atypical antidepressants, and melatonin. In terms of response to treatment, 83.6% of the sample responded (completely or partially), while 16.4% did not respond or were resistant to treatment. Conclusions: This study yielded that psychiatric comorbidity is quite common in the pediatric population with sleep bruxism. The outcomes suggest that bruxism is not only a dental problem but is also associated with a variety of psychopathologies and psychosocial factors. Therefore, health professionals who may encounter bruxism should be aware of the relationship between bruxism and psychopathologies and psychosocial factors. It is recommended that children with bruxism be investigated carefully in a multidisciplinary and holistic approach from a bio-psycho-social perspective and screened for psychosocial and psychiatric difficulties.Öğe Grief Accompanied by Suicidal Thoughts After Traumatic Loss in Adolescent: A Case Report(Sivas Cumhuriyet Üniversitesi, 2024) Şireli, Özlem; Yazarlı, İrem Naz; Abanoz, Elif; Çiçek, Ayla Uzun; Işık, Cansu Mercan; Çolak, MehmetGrief is a normal process that occurs following the irreversible loss of a loved one. This process, characterized by painful experiences, varies widely and is influenced by numerous factors, including the identity of the deceased, the circumstances of their death, the individual characteristics of the bereaved, and the availability of support systems. The suddenness and violence of a loss can disrupt the normal grieving process, leading to the manifestation of traumatic symptoms. This phenomenon, referred to as “traumatic grief” in the literature, is associated with an increased risk of various psychiatric disorders, including major depression, anxiety disorders, and post-traumatic stress disorder. The death of a parent represents a profound loss for an adolescent, complicating their coping mechanisms and significantly impacting their psychological well-being. Parental loss alone is a significant risk factor for suicidal behavior in adolescents. When a parent’s death is traumatic, it can further exacerbate this risk, leading to suicidal thoughts and behaviors by disrupting the normal grief process, even in adolescents who were previously mentally healthy. This article presents the diagnosis and treatment of a 17-year-old girl who exhibited active suicidal thoughts and behaviors after her father was killed with a firearm. The objective of this case report is to explore the atypical grief symptoms that can follow traumatic losses during adolescence and to assess the effectiveness of holistic approaches that combine supportive psychotherapy with pharmacotherapy in treating such cases.Öğe Investigation of Clinical Features and Comorbid Psychopathologies of Children with Sleep Terrors(2024) Şireli, Özlem; Cicek, Ayla Uzun; Abanoz, Elif; Ucuz, İlknur; Naralan, Yüksel SümeyraMethod: Between 2020 and 2024, 51 children who were diagnosed with sleep terror according to DSM-5 diagnostic criteria in 3 different Child and Adolescent Psychiatry clinics were included in the study. The sociodemographic and clinical characteristics of the cases were examined retrospectively through the files. Results: Of the 51 participants, 30 (58.8%) were male, 21 (41.2%) were female and the mean age at the time of admission was 6.76±1.45 years. It was determined that 15 (29.4%) of the cases slept in a noisy environment and 41 (80.4%) of the cases had their sleep interrupted except for sleep terror attacks. At least one psychiatric disorder was detected in 17 (33.3%) patients, and the most common (9.8%) comorbid psychiatric disorder was attention deficit hyperactivity disorder. It was found that complete retrograde amnesia was significantly higher in preschoolers, and motor activity during the attack, physical injury and/or material damage, and full awakening during the attack were significantly higher in school-age children. It was determined that 64.7% of the parents made the wrong intervention during the attack and off-label medication was used in 29.4% of the cases. Conclusion: In sleep terrors, identification of triggering factors and comorbid psychiatric disorders during the diagnostic evaluation process, psychoeducation of parents in treatment, and selection of appropriate medication for medication are very important.Öğe Treatment Complexity in a Twin Adolescent Pair with Selective Mutism: A Case Report(Sivas Cumhuriyet Üniversitesi, 2024) Şireli, Özlem; Pakoz, Seyda Muberra; Soyhan, Merve; Işık, Cansu Mercan; Abanoz, Elif; Çiçek, Ayla UzunSelective Mutism (SM) is a disorder characterized by the individual's persistent inability to speak in specific social situations (e.g., school) where speech is expected, even though the individual is able to speak in other situations. It is a rare anxiety disorder and is often seen in children between the ages of 4-8. The presence of SM in family members is important in terms of both etiology and clinical course. While family burden is a factor that increases the incidence of SM, according to some research results, the clinical symptoms of twin cases diagnosed with SM are more severe than those of non-twins. A positive family history negatively affects the prognosis of SM and increases resistance to treatment. In this article, the diagnosis and treatment process of 14-year-old monozygotic twin adolescents who have been followed up with the diagnosis of SM for a long time will be discussed. The main treatment methods for SM are medication and psychotherapy. It is known that psychotherapeutic interventions in particular vary depending on individual differences. The most important purpose of this article is to draw attention to the differences in treatment interventions of twin SM cases and to evaluate the clinical features of the cases in the light of the literature.
